Apparatus for the treatment of croup and the like



April 15, 1952 s.-Y. GIBBON 2,593,134

I APPARATUS FOR THE TREATMENT OF GROUP AND THE LIKE Filed Nov. 19, 1948 2 T -SHEET 1 mate-i IImIimEg ka .INVENTOR ATTORNEY A ril 15, 1952 s. Y. GIBBON 2,593,134

APPARATUS FOR THE TREATMENT OF GROUP AND THE LIKE Filed NOV. 19, 1948 2 SHEETS-SHEET 2 lNVE QR ATTORNEY Patented Apr. 15, 1952 APPARATUS FOR THE TREATMENT OF GROUP AND THE LIKE Samuel Y. Gibbon, Jenkintown, Pa., assignor to Air-Shields, Inc., Bucks County, Pa., a corporation of Delaware Application November 19, 1948, Serial No. 60,846 9 Claiins. (Cl. 128186) This invention relates to equipment used in the treatment of croup, bronchitis and similar respiratory maladies. It has particular reference to improved apparatus for'generating suitable respiratory gas mixtures and maintaining a high degree of humidity in an enclosed space in which the patient may be located.

In connection with the treatment of croup and I respiratory ailments of this nature, it is usually desirable to supply as close to one hundred per cent humidity as possible in the enclosure in which the patient may be placed. It is also generally desirable to add controlled concentrations of oxygen or oxygen-helium mixtures to the air supplied to the patient. The humidification is usually obtained by providing special cubicles having air circulated therethrough which is constantly exposed to a water spray. In order to obtain sufliciently high humidification a great deal of excess moisture is needed with the spray located immediately adjacent or in the cubicle. As a result, the air often carries droplets of considerable magnitude and these have a tendency to gravitate and condense on objects such as the patients bed clothing, etc., thereby producing a detrimental wetting action. The clothing of attendants entering the cubicles also becomes damp thus increasing the danger of colds or other infections to those attendants who must enter and leave the cubicles at frequent intervals.

With the system of cubicles mentioned above, in spite of the presence of a great deal of moisture the actual humidity of the air in the cubicle is less than would be expected. This is due to the fact that in many cases the size of the water particles in the spray is sufficiently large that they are not properly absorbed by the air to produce the high percentage of humidification desired. The existence of relatively large globules causes them to settle rapidly. During settling some of the finer particles of water vapor are actually removed from the air, since the contact with the larger particles causes droplets to form.

In some cases'steam is used'to produce humidification in special chambers instead of a water spray. This system likewise has certain objectionable features inasmuch as condensation produces a wetting action on objects within the chamber and the high temperature resulting from the use of steam is objectionable both for the patient and the attendants who must enter and leave the chamber periodically.

The present invention has as one of its prin cipal objects the provision of simplified equipment for producing an extremely fine atomized spray which actually becomes a vapor and is thus absorbed into the air to give a high degree of humidification without producing the wetting action above mentioned. 1

Another object of the inventionis to provide equipment which utilizes the controlled pressure flow of any gas which it is desired to supply to the patient such as air, oxygen or oxygen combinations to atomize, mix and deliver the proper humidification to the enclosed space in which the patient breathes.

- A further object of the invention is to provide improved equipment for this general purpose which may be easily folded for compact storage and which is quickly and easily set up for operation. The folding portion of the apparatus relates only to the parts required for supplying an enclosed space about a patient, the humidifying and mixing apparatus being completely assembled as part of the apparatus and ready for immediate use merely by attaching to the source of supply for the oxygen or other gas which is to be added to the air. With apparatus according to the present invention the need for special rooms or cubicles is eliminated and the working conditions of attendants are greatly improved.

Another object of the invention is the provision of a simple control whereby the concentration of oxygen or the like may be varied to suit the needs of the particular situation and also to control the volume of respiratory gas to be delivered. This latter is important in regulating the flow to suit the needs of different patients.

A still further object of the invention is to provide apparatus which permits the attendant to have a clear view of the patient from all directions. This construction preferably provides for a transparent, flexible sheet covering and also a structural wall of transparent material. Such transparent construction for the enclosure has a further beneficial psychological efiect upon patients, especially children, since it permits full view of local activity and eliminates the undesirable cloistered effect of a cubicle or small special chamber. It is also preferred to make the container for the water supply of transparent material thereby permitting the attendant to determine the water supply at a glance. This transparent container construction is also of advantagefor another purpose. It is often desirable to include in the air supply to the patient a medicament such as an aerosol or penicillin which may be 'mixed or dissolved in the water used for humidification. Often such medicaments have distinctive color so that the attendant can tell at a glance which medicament is being used in the container.

How the foregoing and other objects and advantages are attained will be clear from the following description of the drawings, in which- Figure. 1 is a side elevational view of the apparatus of the present invention. Y I

Figure 2 is an end elevational view looking toward the-inside wall 'of the "structure.

Figure 3is a plan view of the apparatus.

Figure 4 is an enlarged view of the upper portion of the frame in folded position.

Figure 5 is a plan view of thelinkage for .supporting the frame in open position.

Figure 6 is an enlarged sectional view taken in the direction of arrows Ii6, Fig. 2.

Figure 7 is a rear elevational view'to an 'enlarged scale of a portion of the external wall showing the humidifying and mixing equipment, the wall of the container being shown in section.

Figure 8 is a sectional view taken in the direction of arrows 8-8, Fig. '7.

Figure 9.is a sectional view takenin'the direction iof:arr.ows-9-'9, Fig. '7.

Referring to the figures, it will be observed that in Figs. 1, 2 and 3, the apparatus is'shown in open position with the framework extended. The equipment utilizes a wall member II, which isflpreferably composed of transparent material such asa clear,jplastic plate. Attached to the 'wall I I and extending horizontally across the top :and the bottom are angles .I2 to which are fastened the framework members which form the occupants space'when the frame is in open'position. The frame includes a side member I3 which consists of a single piece of strap metal formed intheshape indicated in Fig. 1 and pivotally attached to the upper and lower angles I2 :by pivot screws I4. It will be noted that the frame I3 is mounted on the outside surfaces of the angle members I2. The lower leg of frame -'I3xprojects:beyond the wall II to some extent as .-indicated .at I5 in Figs. 1 and 3. Thus, in open position the lower member of the frameextends well beyond the center of gravity of the apparatus and thus provides for greater stability and rigidity of the-apparatus when mounted in position. Asmall notch Na in the lower corner of the wall II allows the extension of leg I5 beyond the wall.

A similar frame member I6 is provided at the opposite side of wall II. It will be noted, however, thatthe frame I6 is mounted by means of pivots IT to the inside surfaces of the upper .and'lower'angles I2. This arrangement of the frames .-I3 and I6 with respect to the angles I2 providesfor proper folding of the framework for storage purposes. framework takes :the position shown in dotted outline M18 in Fig. 3. The relationshipof the parts in'folded position is more clearly. illustrated inFig. 4 where theframe I3 is shown folded abovetheangle I2 whilethe frame I8 is shown folded below thehorizontal surface of theangle When in opentposition the frame members I3 and I6 'are held "properly spaced by means of "linkage composed of'legs I9 and 20. These are illustrated in Figs. 3, 4 and 5. In Fig. 3 the linkage is shown in extended position holding the frames properly spaced. In the full line position of the frame the side members are held a dis- :ta'nce apart suitable for use where the patient is -a'-chil'd and are proportionedto fit inside:a childs crib. Inthis position only thelink I9 is required to support'thelegs I3 and-I6. When alarger patient is to be accommodated the framework may .be supported in a more open position as indicated by dotted outline of the "frame at I3a and I'Ga. In "this position the extension leg 20 of the supporting linkage is'swung into effective position on pivot 2| which connects it to'link I9.

When in folded position the in the enclosure. the complete body may be within the enclosure.

The member or link I9 is pivotally attached to theframe member I3 by'pivot 22. .A stop to restrict the position of link 20 with respect to link I9 when in open position is indicated at 23. The stop 23 engages the slot 24 in link I9 in a manner whichwill be clear by referring to Figs. 3

and-'5. When the link 20 is not being used it is left in folded position with stop 23 falling in slot 2.4a.

When th'e'link I9 is being used to support the framein 'fullline position a pair of small holes .25 in the end of link H are used to fit over matching pins 26 mounted in frame I6. The use of double .pins in this manner provides for fixity of the corner and prevents the frame members from moving from proper position. Similar holes 25a are located atithe end of link 20 to engage pins .26 when the frame is set up inextended position.

When'the apparatus is in operation a transparent'cover, preferably :of flexible, plastic material, is placed over the frame so that the upper portion of the patients body is contained with- In case'the patient is an infant The plastic :cover is indicated in outline in Fig. 3 by the numeral 21. In'order to retain thecover- .ingmaterial 2! inproper position it is'shaped'to properlyfit over the framework and is securely fastened to the 'wall I I by means of fasteners 28 (see Figs. 2 and 6). In the enlarged view of a portion of the wall in Fig. 6, it will be observed that the covering 21 extends around the back portion of the end wall and the external part 29 of the fastener 28is attached to the covering material. The other part 39 of the fastener 28 is attached to the wall II in a depression or .recess which is clearly illustrated at 3|, Fig. 6.

Placing the fasteners 28 in a depression in this manner causes the surface of the material 27 to be drawn down tightly against the wall II,

therebyproducing a relatively tight joint between these parts. A tight joint at this point is required to assure that the gas flushed from the compartment flows out the bottom and thus an appreciable reduction in volume of the liquid in the tank without an excessive lowering of the surface level such as would occur in a deep tank having a -small cross-sectional area. The tank or container 32 is preferably made from transparent material such as plastic or glass in order .to allow easy inspection to determine the amount of liquid in the tank and, in case medications having distinctive colorations are used, to be able to quickly determine the particular medication in the tank or container. A drain cook .33 and a stopper 34 are supplied for the container 32, the portion 35 of the upper surface .of the container beingpreferably .fixed in povsition.

The atomizing and delivery apparatus in the example illustrated are supported on La remov able portion 38 of the upper surface of the container. A standpipe 31 extends from the outside of the container 32 through the lid part 36 to a position close to the bottom of the container.

Inside the standpipe 32 is mounted an atomizer device consisting of the atomizer head 38, a tube 39 extending from head 38 toa point near the bottom of the standpipe 31 and a tube 40 extendingfrom the atomizer head 38 to the mouth of standpipe 31. A De Vilbiss atomizer unit has been found to give satisfactory operation. Mounted on the lid member 36 is a fitting 4| having nipples extending inside and outside of the lid 36;' The inner nipple is connected by means of tubing 42 to the lower end of atomizer tube 49. The outer nipple of fitting 4|v may be connected by means of rubber tubing 43 to a source of gas pressure such as an oxygen tank equipped with a suitable pressure or flow regulator. This unitary assembly of parts on lid 36 simplifies manufacture and also permits the vital parts of the system to be readily accessible for inspection and cleaning.

It will be noted that the head 38 of the atomizer is located just above the upper end of the standpipe 31. The atomizer unit is fixed in this position by means of a perforated diaphragm 44 whichis attached to the inside of the lower pipe 31. With the fluid level in its high position the .top of the atomizer is approximately one diameter above the liquid surface. With a low fluid level the atomizer head will be 2 to 2% pipe diameters above the surface. The upper duct 45 is arranged to be supported with its lower end telescoping inside lower standpipe 31. The upper end of the delivery pipe 45 is formed with a 90 bend andmay be supported on the fitting 46 which projects from the wall II, the connection beingby means of a nut member 41.

The delivery end of the pipe 45 is preferably located four to five pipe diameters above the top of, the atomizer unit 38. foreflective removal of any large liquid particles from the atomizer spray so that only an extremely fine mist is delivered to. the occupants compartment. The arrangement of the atomizer with respect to the liquid level and with respect to the delivery outlet has been especially proportioned to provide for a substantially uniform delivery of moisture and also provides for removal of the larger particles of moisture from the spray due to their impingement upon the inside surfaces of the delivery pipe where the air and mist is required to make a sharp bend into the compartment. I

The air which is mixed with the atomizer mist and the oxygen or other gas being delivered through the atomizer, enters pipe 45 through ports 48 which are located in the delivery pipe 45 at a point just above the atomizer unit 38. In the form o fapparatus shown, three sizes of ports are provided and. control of the inlet to the ports is obtained by means of a collar 49 which surrounds the pipe 45. The operation of the inlet air control will. be seen more clearly from Figs.

7 and 9. In the position illustrated theholes 48 through the large opening. By rotating thecollar 49 to a second position wherein" the openings 50 are in registry with the intermediate sized ports 48a in the pipe 45, a lesser amount of air is drawn in for delivery to the compartment. The minimum setting for air delivery is obtained sized openings 48b in the pipe 45. A slot 5| is provided in the collar 49 anda pin 52 is mounted This location provides be provided on the collar and the pipe to indicate to the attendant the opening which is being used. In the present arrangement the openings have been so located and proportioned that in case the collar 49 is accidently rotated to an intermediate position the hole 50 will always uncover a suificient area of adjusting pipe openings to provide for a minimum intake equal to the air intake of the small opening 481). This amount ofopening provides for suificient airflow through the compartment to flush out the carbon dioxide generated by an adult patient. This overlap arrangement for the openings pro- }vides an important safety feature.

With apparatus as described, it is desirable that a constant pressure he used, in the gas sup- .ply connection 43 to the source of supply of gas which is to be used such as an oxygen tank.

.[With the delivery of 4 litres of oxygen per min.

through the atomizer and with the small air inlet opening, approximately 11 litres of gas mix:

ture per minutemay be delivered to the compartment with an oxygen concentration of about '50 per cent. With the large opening and: the same 4 litres of oxygen delivered through the atomizer unit approximately. 24 litres per minute are delivered to the occupants compartment with an oxygen concentration of approximately 35 per cent. With all settings, a high humidity may be developed ranging from 93 to 96 per cent, this high degree of humidity being available without appreciable condensation which might cause undesirable wetting action in the compartment. Such values were measured under conditions where comparative tests with spray rooms showed only 60 to 70 per cent humidity with outside air at per cent humidity.

From the foregoing description, it will be evident that I have provided equipment for the treatment of croup and the like, which is greatly simplified both in the manner of operation and 1 in actual construction over previousequipment for this purpose. Thesimple folding arrangement allows the apparatus to be stored in an extremely small space and at the same time perthe system is not only simple but has been pro- I portioned to provide for maximum effectiveness 'of the atomizer and gas delivery action to properly draw in and mix the air being delivered to the compartment. The safety construction of the air inlet assures suflicient flow at all times to give proper flushing of the carbon dioxide. The

delivery pipe arrangement has also been proporin the pipe and the holes 59 in the collar are in registry, thus permitting air to enter the pipe tioned to deliver a fine mist or nebulized spray which is readily absorbed into the air and gas mixture in a fashion which provides a high del 'gree of humidification without appreciable unde- -19 by bringing ports 50 into registry with the small sirable condensation and wetting action inside "the compartment.

I claim: 7 v 1. Portable apparatus for use in the treatment 'ofcroup and similar maladies including a humidifier tank, said tank having a removable lid, a

motion of the collar 49. Suitable markings may standpipe supported on said lid and adapted to project into said tank when the lid is in position, an atomizer unit supported in said standpipe, said atomizer unit having a channel adapted to project into said tank so that its lower end is below the surface of the liquid when the humidifier is in use, said atomizer unit having a second channel, a connecting fitting mounted on said lid suitable for connecting to alsource of gas pressure, and a tubular member connecting said itting on the inside of said lid to said second channel of the atomizer unit.

2. For humidifier apparatus suitable for treatment of respiratory ailments, a wall member forming one end of the occupants enclosure, a fluid container supported on said wall member, a single delivery channel to said enclosure in the form of a vertical pipe assembly leading upwardly from said container, the upper end of said pipe assembly having an elbow connecting the pipe to the occupants space, an atomizer device located inthe lower portion of said pipe assembly, said device having a head with a connecting channel for delivery of gas and a connecting channel for delivery of liquid from said fluid container.

3. Apparatus for the treatment of respiratory ailments including a wall member, a fluid container, a pipe assembly leading from said fluid container through said wall member to the occupants compartment, said pipe assembly having a lower straight portion leading from the upper surface of said container and projecting downwardly into said container, an-upper pipe member incorporating a ninety degree elbow at its upper end adapted for attachment to the wall member and for telescopic engagement with the lower portion, the lower end of the upper pipe member being adapted to fit inside the upper end of the lower portion, an atomizer device supported in the lower portion of the pipe, said upper pipe member having an adjustable air inlet opening therein to permit air to enter under the influence of the reduced pressure produced inside said pipe by the velocity developed by the flow from said atomizer device.

4. Apparatus for treatment of croup and the like including a wall member, a fluid container, a single, direct delivery pipe leading from said fluid container through said wall member for delivery of respiratory gas, an atomizer unit comprising a nozzle member having attachments for the delivery thereto of both respiratory gas and fluid,

said unit being supported with its head located at a point above the top of said container, said pipe having an opening in the wall thereof at a point adjacent said atomizer head.

5. For humidifier apparatus suitable for treatment of respiratory ailments, a compartment wall member, a fluid container, a gas delivery pipe leading from said fluid container through said wall'member, an atomizer device associated with said container, said pipe having a plurality of openings therein to permit the entry of outside air into said pipe under the influence of reduced pressure developed by the action of said atomizer device, a rotatable collar adapted to fit around said pipe and having an opening therein, adjustment of-the air intake being by rotation of said collar to provide for registry of different openings with the opening in said collar.

'6. For humidifier apparatus suitable for treatment of respiratory ailments, a compartment wall member, a fluid container, a gas delivery pipe leading from said fluid container through said wall member, an atomizer device associated with said, container for delivering .a spray into said pipe, said pipe having a'plurality of openings therein topermit entry of outsideair thereto under the influence of reduced pressure developed by the action of said atomizer device, a rotatable collar adapted to fit around said pipe and having an opening therein, adjustment of the air intake being by rotation of said collar to provide for registry of different openings with the'opening in said collar, the openings in said pipe and said collar being so located and proportioned that in any intermediate position of adjustment of said collar an air inlet sufficient to supply at least minimum requirements is provided.

7. Apparatus for use in the treatment of croup and the like including a wall member adapted to form an end of an occupants enclosure, equipment for supplying and conditioning respiratory gas for delivery to the occupants compartment including a liquid container, and a delivery pipe supported on the exterior surface of said wall, framework for supporting a covering to form additional walls of the enclosure, said framework having two side frames pivotally mounted with respect to said wall members to allow said side frames to fold into a plane closely parallel to said wall member, a rod structure adapted to connect the outer ends of said frames in their open position, said rod structure having a connection for attaching it to one of said frames, said'connection incorporating a pair of pins adapted to engage a pair of mating holes whereby fixation may be provided between said frame and said rod structure.

8. For apparatus for the treatment of croup and the like, a wall structure having a liquid container and an air delivery pipe mounted on the outer surface, a frame attached to said wall structure to form an occupants enclosure, a transparent flexible cover adapted to fit over said frame and attach to the outer surface of said wall structure, the attachment means comprising a plurality of snap fasteners, one part of each being mounted on said wall structure in a cylindrical depression and the other part of each being fastened to the edge of said cover so that when said cover is snapped in position on said frame, the cover is drawn tightly against said wall structure to form a close fitting joint.

9. Portable apparatus for use in the treatment of croup and similar maladies including a wall member forming one side of an occupants compartment, humidifier equipment mounted on said wall member incorporating a tank and large diameter delivery pipe mounted parallel to said wall member, said delivery pipe having an elbow at its delivery end, an atomizer unit mounted inside said pipe, said unit including a nozzle with a connection for delivery of gas thereto and a channel structure adapted to project into said tank, said pipe forming a single, direct delivery channel from said atomizer to the occupants compartment.

SAMUEL Y. GIBBON.

REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS 

